Search results for: total diet study
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 52150

Search results for: total diet study

45130 Recycling of End of Life Concrete Based on C2CA Method

Authors: Somayeh Lotfi, Manuel Eggimann, Eckhard Wagner, Radosław Mróz, Jan Deja

Abstract:

One of the main environmental challenges in the construction industry is a strong social force to decrease the bulk transport of the building materials in urban environments. Considering this fact, applying more in-situ recycling technologies for Construction and Demolition Waste (CDW) is an urgent need. The European C2CA project develops a novel concrete recycling technology that can be performed purely mechanically and in situ. The technology consists of a combination of smart demolition, gentle grinding of the crushed concrete in an autogenous mill, and a novel dry classification technology called ADR to remove the fines. The feasibility of this recycling process was examined in demonstration projects involving in total 20,000 tons of End of Life (EOL) concrete from two office towers in Groningen, The Netherlands. This paper concentrates on the second demonstration project of C2CA, where EOL concrete was recycled on an industrial site. After recycling, the properties of the produced Recycled Aggregate (RA) were investigated, and results are presented. An experimental study was carried out on mechanical and durability properties of produced Recycled Aggregate Concrete (RAC) compared to those of the Natural Aggregate Concrete (NAC). The aim was to understand the importance of RA substitution, w/c ratio and type of cement to the properties of RAC. In this regard, two series of reference concrete with strength classes of C25/30 and C45/55 were produced using natural coarse aggregates (rounded and crushed) and natural sand. The RAC series were created by replacing parts of the natural aggregate, resulting in series of concrete with 0%, 20%, 50% and 100% of RA. Results show that the concrete mix design and type of cement have a decisive effect on the properties of RAC. On the other hand, the substitution of RA even at a high percentage replacement level has a minor and manageable impact on the performance of RAC. This result is a good indication towards the feasibility of using RA in structural concrete by modifying the mix design and using a proper type of cement.

Keywords: C2CA, ADR, concrete recycling, recycled aggregate, durability

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45129 The Role of Polyphenolic Compounds in the Alpha Amylase and Alpha Glucosidase Inhibitory Potentials of Extracts from the Leaves of Acalypha godseffiana from Eastern Nigeria: An in-vitro Study

Authors: A. K. Asekunowo, A O. T. Asafa, O. O. Okoh, O. T. Asekun, O. B. Familoni

Abstract:

Background: Acalypha godseffiana is an important plant used both as an ornamental and herbs; its leaves are employed in management of diseases such as diabetics in Eastern Nigeria. Aim: The correlations of the polyphenolic compounds in the hypoglycemic potential of different extracts of leaves of A. godseffiana and their safety profile on cell lines were investigated. Materials and Methods: The phytochemical compositions and antioxidants potentials were determined using adopted methods. An in vitro approach was employed in determining the hypoglycemic potentials of the extracts on α-amylase and α-glucosidase. The Line weaver-Burke plot was used to evaluate the mechanisms of Inhibition mechanisms of the enzymes. Results and Conclusions: Antioxidants results revealed that total antioxidant capacity (TAC) of the acetone extract (IC50: 0.34 mg/mL) showed better activity compared to the standards (silymarine 0.52 mg/mL; gallic acid 0.51 mg/mL). In-vitro hypoglycemic activity of the extracts confirmed that acetone extract demonstrated strong and mild inhibitory potential against α-amylase and α-glucosidase respectively. The observed activity was concentration-dependent with IC50 values of 2.33 and 0.13 mg/mL. The observed hypoglycemic and anti-oxidant potentials of acetone extract A. godseffiana correlate to its high polyphenolic contents which include phenols (133.20 mg gallic acid g-1), flavonoid (350.60 mg quercetin g-1) and tannins (264.67 mg catechin g-1). The mechanisms of action exhibited by acetone extract of A. godseffiana were mixed non-competitive and uncompetitive; which can be attributed to its inhibitory properties on α-amylase and α-glucosidase respectively. This effect would cause reduction in the rate at which starch hydrolyse, boost palliated glucose levels; hence, making acetone extract of A. godseffiana a potential anti-hypoglycemic alternative.

Keywords: Acalypha godeseffiana, acetone extract, anti-hypoglycemia, antioxidant, phytochemicals

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45128 NDVI as a Measure of Change in Forest Biomass

Authors: Amritansh Agarwal, Tejaswi Agarwal

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Forest ecosystem plays very important role in the global carbon cycle. It stores about 80% of all above ground and 40% of all below ground terrestrial organic carbon. There is much interest in the extent of tropical forests and their rates of deforestation for two reasons: greenhouse gas contributions and the impact of profoundly negative biodiversity. Deforestation has many ecological, social and economic consequences, one of which is the loss of biological diversity. The rapid deployment of remote sensing (RS) satellites and development of RS analysis techniques in the past three decades have provided a reliable, effective, and practical way to characterize terrestrial ecosystem properties. Global estimates of tropical deforestation vary widely and range from 50,000 to 170,000 km2 /yr Recent FAO tropical deforestation estimates for 1990–1995 cite 116,756km2 / yr globally. Remote Sensing can prove to be a very useful tool in monitoring of forests and associated deforestation to a sufficient level of accuracy without the need of physically surveying the forest areas as many of them are physically inaccessible. The methodology for the assessment of forest cover using digital image processing (ERDAS) has been followed. The satellite data for the study was procured from USGS website in the digital format. While procuring the satellite data, care was taken to ensure that the data was cloud and aerosol free by making using of FLAASH atmospheric correction technique. The Normalized Difference Vegetation Index (NDVI) has been used as a numerical indicator of the reduction in ground biomass. NDVI = (near I.R - Red)/ (near I.R + Red). After calculating the NDVI variations and associated mean we have analysed the change in ground biomass. Through this paper we have tried to indicate the rate of deforestation over a given period of time by comparing the forest cover at different time intervals. With the help of remote sensing and GIS techniques it is clearly shows that the total forest cover is continuously degrading and transforming into various land use/land cover category.

Keywords: remote sensing, deforestation, supervised classification, NDVI change detection

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45127 Desodesmus sp.: A Potential Micro Alga to Treat the Textile Wastewater

Authors: Thirunavoukkarasu Manikkannan, Karpanai Selvan Balasubramanian

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Textile industry is the one of the most important industrial sector in India. It accounts for 5% of total Gross Domestic Product (GDP) in the country. A Textile industry consumes large quantities of water (~250 m3/ton of product) and they generate almost ~90% of wastewater from its consumption. The problem is alarming and requires proper treatment process to acquire dual benefit of Zero Liquid Discharge and no contamination to the environment. Here we describe the process by which the textile wastewater can be reused. We have collected the textile wastewater in and around Ayyampettai area of Tamilnadu, India. Among different microalgal strains used, Desodesmus sp. collected at Manali, Chennai, Tamilnadu, India was able to lessen the colour of the waste water in 12-15 hrs of its growth, COD around 81.7%, Dissolved solid reduction was 28 ± 0.5 %, Suspended solid was reduced to 40.5 ± 0.3 %, Dye degradation was 50-78%. Further, Desodesmus sp. able to achieve the biomass of 0.9 ± 0.2 g/L (dry weight) in two weeks’ time, the Chl a content was 11 mg/L. It infers that this algal strain able to utilize the textile wastewater as source for growth and algal biomass production.

Keywords: Desodesmus sp., microalgae, textile, treatment, wastewater

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45126 Integrative Review: Impact of Transitional Care on Self-Management of Chronic Conditions in Un/Underinsured Populations

Authors: Ashleigh Medina

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Chronic conditions account for the majority of total health care spending both in the United States and globally. Encouraging self-management to improve chronic conditions, which in turn could decrease the strain placed on hospitals, requires resources to address the patient’s social concerns in addition to their medical concerns. Transitional care has been identified as a possible bridge between acutely managing conditions at the hospital to chronically managing conditions in a community setting. The aim of this integrative review was to examine the impact of transitional care on self-management outcomes of chronic conditions in un/underinsured populations. Both transitional care, by assisting with resources such as funding sources for healthcare and medications or identifying a healthcare provider for continued care, and self-management, by increasing responsibility for one’s care through goal setting and taking action, can impact health outcomes while providing health care cost-savings.

Keywords: chronic conditions, self-management, transitional care, uninsured

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45125 Energy Savings with the Use of LED Lights at the Wastewater Treatment Plant

Authors: Kishen Prathivadi

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The Sewer Authority Mid-Coastside (SAM) is a Joint Powers Authority formed in 1976 and provides secondary wastewater treatment to an average flow of 2.0 million gallons per day. SAM owns and operates a Wastewater Treatment Plant (WWTP) and a sanitary sewage collection system that collects sewage from its three member agencies: the City of Half Moon Bay, the Granada Community Services District and Montara Water and Sanitary District. The Sewer Authority Mid-Coastside (SAM) partnered with Pacific Gas & Electric, and its contractor GEL America, to review and replace all inefficient lighting fixtures and bulbs at the SAM treatment plant and administrative office. The project focused on replacing old and inefficient lighting fixtures and bulbs, reducing annual operating and maintenance costs, and reducing SAM’s carbon footprint. The project resulted in a 55% overall energy reduction, higher light quality and acuity, and a total operational savings of $495,000 over ten years.

Keywords: energy savings, LED, lighting, electrical

Procedia PDF Downloads 134
45124 Drug Use Knowledge and Antimicrobial Drug Use Behavior

Authors: Pimporn Thongmuang

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The import value of antimicrobial drugs reached approximately fifteen million Baht in 2010, considered as the highest import value of all modern drugs, and this value is rising every year. Antimicrobials are considered the hazardous drugs by the Ministry of Public Health. This research was conducted in order to investigate the past knowledge of drug use and Antimicrobial drug use behavior. A total of 757 students were selected as the samples out of a population of 1,800 students. This selected students had the experience of Antimicrobial drugs use a year ago. A questionnaire was utilized in this research. The findings put on the view that knowledge gained by the students about proper use of antimicrobial drugs was not brought into practice. This suggests that the education procedure regarding drug use needs adjustment. And therefore the findings of this research are expected to be utilized as guidelines for educating people about the proper use of antimicrobial drugs. At a broader perspective, correct drug use behavior of the public may potentially reduce drug cost of the Ministry of Public Health of Thailand.

Keywords: drug use knowledge, antimicrobial drugs, drug use behavior, drug

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45123 Combination of Diane-35 and Metformin to Treat Early Endometrial Carcinoma in PCOS Women with Insulin Resistance

Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

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Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

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45122 Giving Right-of-Way to Emergency Ambulances: Attitude and Behavior of Road Users in Developing Countries

Authors: Mahmoud T. Alwidyan, Ahmad Alrawashdeh, Alaa O. Oteir

Abstract:

Background: Emergency medical service (EMS) providers, oftentimes, use the lights and sirens (L&S) of their ambulances to warn road users, navigate through traffic, and expedite transport to save lives of ill and injured patients. Despite the contribution of road users in the effectiveness of reducing transport time of EMS ambulances using L&S, there is a lack of empirical assessments exploring the road user’s attitude and behavior in such situations. This study, therefore, aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use. Methods: This was a cross-sectional survey developed and distributed to adult road users in Northern Jordan. The questionnaire included 20 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants’ responses and assessed the association between demographics and attitude statements using logistic regression. Results: A total of 1302 questionnaires were complete and appropriate for analysis. The mean age was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) in our sample would perform inappropriate action in response to EMS ambulances with L&S in use. The multivariate logistic regression model show that being female (OR, 0.63; 95% CI = 0.48-0.81), more educated (OR, 0.68; 95% CI = 0.53-0.86), or public transport driver (OR, 0.55; 95% CI = 0.34-0.90) is significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as crossing red traffic lights or following the passing by EMS ambulances, which would, in turn, increase the risk on ambulances and other road users. Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances, and many engage in risky driving behaviors due perhaps to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior, which, in turn, improves the efficiency of ambulance services.

Keywords: EMS ambulances, lights and sirens, road users, attitude and behavior

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45121 Effect of Volcanic Ash and Recycled Aggregates in Concrete

Authors: Viviana Letelier, Ester Tarela, Giacomo Moriconi

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The cement industry is responsible for around a 5% of the CO2 emissions worldwide and considering that concrete is one of the most used materials in construction its total effect is important. An alternative to reduce the environmental impact of concrete production is to incorporate certain amount of residuals in the dosing, limiting the replacement percentages to avoid significant losses in the mechanical properties of the final material. This study analyses the variation in the mechanical properties of structural concretes with recycled aggregates and volcanic ash as cement replacement to test the effect of the simultaneous use of different residuals in the same material. Analyzed concretes are dosed for a compressive strength of 30MPa. The recycled aggregates are obtained from prefabricated pipe debris with a compressive strength of 20MPa. The volcanic ash was obtained from the Ensenada (Chile) area after the Calbuco eruption in April 2015. The percentages of natural course aggregates that are replaced by recycled aggregates are of 0% and 30% and the percentages of cement replaced by volcanic ash are of 0%, 5%, 10% and 15%. The combined effect of both residuals in the mechanical properties of the concrete is evaluated through compressive strength tests after, 28 curing days, flexural strength tests after 28 days, and the elasticity modulus after 28 curing days. Results show that increasing the amount of volcanic ash used increases the losses in compressive strength. However, the use of up to a 5% of volcanic ash allows obtaining concretes with similar compressive strength to the control concrete, whether recycled aggregates are used or not. Furthermore, the pozzolanic reaction that occurs between the amorphous silica and the calcium hydroxide (Ca(OH)2) provokes an increase of a 10% in the compressive strength when a 5% of volcanic ash is combined with a 30% of recycled aggregates. Flexural strength does not show significant changes with neither of the residues. On the other hand, decreases between a 14% and a 25% in the elasticity modulus have been found. Concretes with up to a 30% of recycled aggregates and a 5% of volcanic ash as cement replacement can be produced without significant losses in their mechanical properties, reducing considerably the environmental impact of the final material.

Keywords: compressive strength of recycled concrete, mechanical properties of recycled concrete, recycled aggregates, volcanic ash as cement replacement

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45120 D-Wave Quantum Computing Ising Model: A Case Study for Forecasting of Heat Waves

Authors: Dmytro Zubov, Francesco Volponi

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In this paper, D-Wave quantum computing Ising model is used for the forecasting of positive extremes of daily mean air temperature. Forecast models are designed with two to five qubits, which represent 2-, 3-, 4-, and 5-day historical data respectively. Ising model’s real-valued weights and dimensionless coefficients are calculated using daily mean air temperatures from 119 places around the world, as well as sea level (Aburatsu, Japan). In comparison with current methods, this approach is better suited to predict heat wave values because it does not require the estimation of a probability distribution from scarce observations. Proposed forecast quantum computing algorithm is simulated based on traditional computer architecture and combinatorial optimization of Ising model parameters for the Ronald Reagan Washington National Airport dataset with 1-day lead-time on learning sample (1975-2010 yr). Analysis of the forecast accuracy (ratio of successful predictions to total number of predictions) on the validation sample (2011-2014 yr) shows that Ising model with three qubits has 100 % accuracy, which is quite significant as compared to other methods. However, number of identified heat waves is small (only one out of nineteen in this case). Other models with 2, 4, and 5 qubits have 20 %, 3.8 %, and 3.8 % accuracy respectively. Presented three-qubit forecast model is applied for prediction of heat waves at other five locations: Aurel Vlaicu, Romania – accuracy is 28.6 %; Bratislava, Slovakia – accuracy is 21.7 %; Brussels, Belgium – accuracy is 33.3 %; Sofia, Bulgaria – accuracy is 50 %; Akhisar, Turkey – accuracy is 21.4 %. These predictions are not ideal, but not zeros. They can be used independently or together with other predictions generated by different method(s). The loss of human life, as well as environmental, economic, and material damage, from extreme air temperatures could be reduced if some of heat waves are predicted. Even a small success rate implies a large socio-economic benefit.

Keywords: heat wave, D-wave, forecast, Ising model, quantum computing

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45119 Attitude in Academic Writing (CAAW): Corpus Compilation and Annotation

Authors: Hortènsia Curell, Ana Fernández-Montraveta

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This paper presents the creation, development, and analysis of a corpus designed to study the presence of attitude markers and author’s stance in research articles in two different areas of linguistics (theoretical linguistics and sociolinguistics). These two disciplines are expected to behave differently in this respect, given the disparity in their discursive conventions. Attitude markers in this work are understood as the linguistic elements (adjectives, nouns and verbs) used to convey the writer's stance towards the content presented in the article, and are crucial in understanding writer-reader interaction and the writer's position. These attitude markers are divided into three broad classes: assessment, significance, and emotion. In addition to them, we also consider first-person singular and plural pronouns and possessives, modal verbs, and passive constructions, which are other linguistic elements expressing the author’s stance. The corpus, Corpus of Attitude in Academic Writing (CAAW), comprises a collection of 21 articles, collected from six journals indexed in JCR. These articles were originally written in English by a single native-speaker author from the UK or USA and were published between 2022 and 2023. The total number of words in the corpus is approximately 222,400, with 106,422 from theoretical linguistics (Lingua, Linguistic Inquiry and Journal of Linguistics) and 116,022 from sociolinguistics journals (International Journal of the Sociology of Language, Language in Society and Journal of Sociolinguistics). Together with the corpus, we present the tool created for the creation and storage of the corpus, along with a tool for automatic annotation. The steps followed in the compilation of the corpus are as follows. First, the articles were selected according to the parameters explained above. Second, they were downloaded and converted to txt format. Finally, examples, direct quotes, section titles and references were eliminated, since they do not involve the author’s stance. The resulting texts were the input for the annotation of the linguistic features related to stance. As for the annotation, two articles (one from each subdiscipline) were annotated manually by the two researchers. An existing list was used as a baseline, and other attitude markers were identified, together with the other elements mentioned above. Once a consensus was reached, the rest of articles were annotated automatically using the tool created for this purpose. The annotated corpus will serve as a resource for scholars working in discourse analysis (both in linguistics and communication) and related fields, since it offers new insights into the expression of attitude. The tools created for the compilation and annotation of the corpus will be useful to study author’s attitude and stance in articles from any academic discipline: new data can be uploaded and the list of markers can be enlarged. Finally, the tool can be expanded to other languages, which will allow cross-linguistic studies of author’s stance.

Keywords: academic writing, attitude, corpus, english

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45118 Strategic Metals and Rare Earth Elements Exploration of Lithium Cesium Tantalum Type Pegmatites: A Case Study from Northwest Himalayas

Authors: Auzair Mehmood, Mohammad Arif

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The LCT (Li, Cs and Ta rich)-type pegmatites, genetically related to peraluminous S-type granites, are being mined for strategic metals (SMs) and rare earth elements (REEs) around the world. This study investigates the SMs and REEs potentials of pegmatites that are spatially associated with an S-type granitic suite of the Himalayan sequence, specifically Mansehra Granitic Complex (MGC), northwest Pakistan. Geochemical signatures of the pegmatites and some of their mineral extracts were analyzed using Inductive Coupled Plasma Mass Spectroscopy (ICP-MS) technique to explore and generate potential prospects (if any) for SMs and REEs. In general, the REE patterns of the studied whole-rock pegmatite samples show tetrad effect and possess low total REE abundances, strong positive Europium (Eu) anomalies, weak negative Cesium (Cs) anomalies and relative enrichment in heavy REE. Similar features have been observed on the REE patterns of the feldspar extracts. However, the REE patterns of the muscovite extracts reflect preferential enrichment and possess negative Eu anomalies. The trace element evaluation further suggests that the MGC pegmatites have undergone low levels of fractionation. Various trace elements concentrations (and their ratios) including Ta versus Cs, K/Rb (Potassium/Rubidium) versus Rb and Th/U (Thorium/Uranium) versus K/Cs, were used to analyze the economically viable mineral potential of the studied rocks. On most of the plots, concentrations fall below the dividing line and confer either barren or low-level mineralization potential of the studied rocks for both SMs and REEs. The results demonstrate paucity of the MGC pegmatites with respect to Ta-Nb (Tantalum-Niobium) mineralization, which is in sharp contrast to many Pan-African S-type granites around the world. The MGC pegmatites are classified as muscovite pegmatites based on their K/Rb versus Cs relationship. This classification is consistent with the occurrence of rare accessory minerals like garnet, biotite, tourmaline, and beryl. Furthermore, the classification corroborates with an earlier sorting of the MCG pegmatites into muscovite-bearing, biotite-bearing, and subordinate muscovite-biotite types. These types of pegmatites lack any significant SMs and REEs mineralization potentials. Field relations, such as close spatial association with parent granitic rocks and absence of internal zonation structure, also reflect the barren character and hence lack of any potential prospects of the MGC pegmatites.

Keywords: exploration, fractionation, Himalayas, pegmatites, rare earth elements

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45117 Optimal Production Planning in Aromatic Coconuts Supply Chain Based on Mixed-Integer Linear Programming

Authors: Chaimongkol Limpianchob

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This work addresses the problem of production planning that arises in the production of aromatic coconuts from Samudsakhorn province in Thailand. The planning involves the forwarding of aromatic coconuts from the harvest areas to the factory, which is classified into two groups; self-owned areas and contracted areas, the decisions of aromatic coconuts flow in the plant, and addressing a question of which warehouse will be in use. The problem is formulated as a mixed-integer linear programming model within supply chain management framework. The objective function seeks to minimize the total cost including the harvesting, labor and inventory costs. Constraints on the system include the production activities in the company and demand requirements. Numerical results are presented to demonstrate the feasibility of coconuts supply chain model compared with base case.

Keywords: aromatic coconut, supply chain management, production planning, mixed-integer linear programming

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45116 Treatment Outcome Of Corneal Ulcers Using Levofloxacin Hydrate 1.5% Ophthalmic Solution And Adjuvant Oral Ciprofloxacin, A Treatment Strategy Applicable To Primary Healthcare

Authors: Celine Shi Ying Lee, Jong Jian Lee

Abstract:

Background: Infectious keratitis is one of the leading causes of blindness worldwide. Prompt treatment with effective medication will control the infection early, preventing corneal scarring and visual loss. fluoroquinolones ophthalmic medication is used because of its broad-spectrum properties, potency, good intraocular penetration, and low toxicity. The study aims to evaluate the treatment outcome of corneal ulcers using Levofloxacin 1.5% ophthalmic solution (LVFX) with adjuvant oral ciprofloxacin when indicated and apply this treatment strategy in primary health care as first-line treatment. Methods: Patients with infective corneal ulcer treated in an eye center were recruited. Inclusion criteria includes Corneal infection consistent with bacterial keratitis, single or multiple small corneal ulcers. Treatment regime: LVFX hourly for the first 2 days, 2 hourly from the 3rd day, and 3 hourly on the 5th day of review. Adjuvant oral ciprofloxacin 500mg BD was administered for 5 days if there were multiple corneal ulcers or when the location of the cornea ulcer was central or paracentral. Results: 47 subjects were recruited. There were 16 (34%) males and 31 (66%) females. 40 subjects (85%) were contact lens (CL) related to corneal ulcer, and 7 subjects (15%) were non-contact lens related. 42 subjects (89%) presented with one ulcer, of which 20 of them (48%) needed adjuvant therapy. 5 subjects presented with 2 or 3 ulcers, of which 3 needed adjuvant therapy. A total of 23 subjects (49%) was given adjuvant therapy (oral ciprofloxacin 500mg BD for 5 days).21 of them (91%) were CL related. All subjects recovered fully, and the average duration of treatment was 3.7 days, with 49% of the subjects resolved on the 3rd day, 38% on the 5thday of and 13% on the 7thday. All subjects showed symptoms of relief of pain, light-sensitivity, and redness on the 3rd day with full visual recovery post-treatment. No adverse drug reactions were recorded. Conclusion: Our treatment regime demonstrated good clinical outcome as first-line treatment for corneal ulcers. A corneal ulcer is a common eye condition in Singapore, mainly due to CL wear. Pseudomonas aeruginosa is the most frequent and potentially sight-threatening pathogen involved in CL related corneal ulcer. Coagulase-negative Staphylococci, Staphylococcus aureus, and Streptococcus Pneumoniae were seen in non-CL users. All these bacteria exhibit good sensitivity rates to ciprofloxacin and levofloxacin. It is therefore logical in our study to use LVFX Eyedrops and adjuvant ciprofloxacin oral antibiotics when indicated as first line treatment for most corneal ulcers. Our study of patients, both CL related and non-CL related, have shown good clinical response and full recovery using the above treatment strategy. There was also a full restoration of visual acuity in all the patients. Eye-trained primary Healthcare practitioners can consider adopting this treatment strategy as first line treatment in patients with corneal ulcers. This is relevant during the COVID pandemic, where hospitals are overwhelmed with patients and in regions with limited access to specialist eye care. This strategy would enable early treatment with better clinical outcome.

Keywords: corneal ulcer, levofloxacin hydrate, treatment strategy, ciprofloxacin

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45115 Colonization of Candida Albicans on 3D Printed CAD/CAM Complete Denture Versus Conventional Complete Denture: Randomized Controlled Clinical Study

Authors: Eman Helal, Ahmed M. Esmat

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Statement of problem: The development of computer-aided design/computer-aided manufacturing (CAD/CAM) resin dentures has simplified complete denture production. Most of the studies evaluated the mechanical properties of the material, but the hygienic performance of the CAD /CAM denture and their ability to maintain clean surfaces and minimize bacterial accumulation is still lacking. Purpose evaluation of the antibacterial characteristics of the 3D printed CAD/CAM denture and to compare it with the conventional heat polymerized acrylic denture base material. Methodology a total of thirty completely edentulous patients grouped randomly into two groups (Group I: Control group) received conventional heat polymerized acrylic resin complete dentures, (Group II: Test group) received 3D printed (CAD/CAM) dentures (stereolithographic PMMA), Samples of Candida albicans culture swabs were taken after 1 month and 3 months of dentures` insertion. A culture swab was obtained by scrubbing the fitting surface of the upper denture. At each time interval, three swab samples were collected from each patient and were inoculated in three individual culture media. Results: there was a significant difference in the colonization of Candida albicans to the fitting surface of the dentures between both groups (Group I: Conventional denture cases) exhibited more adhesion of Candida Albicans to the fitting surface than did (Group II: CAD/CAM cases) (P<0.05). Conclusion: 3D printed CAD/CAM complete denture showed minimal Candida adherence upon upper denture fitting compared to conventional heat-polymerized acrylic resin, which contributes to decreasing the incidence of denture stomatitis which is considered one of the most common problems among complete denture wearers.

Keywords: CAD/CAM denture, completely edentulous, elderly patients, 3D printing, antimicrobial efficiency, conventional denture, PMMA, Candida Albicans, denture stomatitis

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45114 A Reinforcement Learning Approach for Evaluation of Real-Time Disaster Relief Demand and Network Condition

Authors: Ali Nadi, Ali Edrissi

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Relief demand and transportation links availability is the essential information that is needed for every natural disaster operation. This information is not in hand once a disaster strikes. Relief demand and network condition has been evaluated based on prediction method in related works. Nevertheless, prediction seems to be over or under estimated due to uncertainties and may lead to a failure operation. Therefore, in this paper a stochastic programming model is proposed to evaluate real-time relief demand and network condition at the onset of a natural disaster. To address the time sensitivity of the emergency response, the proposed model uses reinforcement learning for optimization of the total relief assessment time. The proposed model is tested on a real size network problem. The simulation results indicate that the proposed model performs well in the case of collecting real-time information.

Keywords: disaster management, real-time demand, reinforcement learning, relief demand

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45113 Early Initiation of Breastfeeding and Its Determinants among Non-Caesarean Deliveries at Primary and Secondary Health Facilities: A Case Observational Study

Authors: Farhana Karim, Abdullah N. S. Khan, Mohiuddin A. K. Chowdhury, Nabila Zaka, Alexander Manu, Shams El Arifeen, Sk Masum Billah

Abstract:

Breastfeeding, an integral part of newborn care, can reduce 55-87% of all-cause neonatal mortality and morbidity. Early initiation of breastfeeding within 1 hour of birth can avert 22% of newborn mortality. Only 45% of world’s newborns and 42% of newborns in South-Asia are put to the breast within one hour of birth. In Bangladesh, only a half of the mothers practice early initiation of breastfeeding which is less likely to be practiced if the baby is born in a health facility. This study aims to generate strong evidence for early initiation of breastfeeding practices in the government health facilities and to explore the associated factors influencing the practice. The study was conducted in selected health facilities in three neighbouring districts of Northern Bangladesh. Total 249 normal vaginal delivery cases were observed for 24 hours since the time of birth. The outcome variable was initiation of breastfeeding within 1 hour while the explanatory variables included type of health facility, privacy, presence of support person, stage of labour at admission, need for augmentation of labour, complications during delivery, need for episiotomy, spontaneous cry of the newborn, skin-to-skin contact with mother, post-natal contact with the service provider, receiving a post-natal examination and counselling on breastfeeding during postnatal contact. The simple descriptive statistics were employed to see the distribution of samples according to socio-demographic characteristics. Kruskal-Wallis test was carried out for testing the equality of medians among two or more categories of each variable and P-value is reported. A series of simple logistic regressions were conducted with all the potential explanatory variables to identify the determining factors for breastfeeding within 1 hour in a health facility. Finally, multiple logistic regression was conducted including the variables found significant at bi-variate analyses. Almost 90% participants initiated breastfeeding at the health facility and median time to initiate breastfeeding was 38 minutes. However, delivering in a sub-district hospital significantly delayed the breastfeeding initiation in comparison to delivering in a district hospital. Maintenance of adequate privacy and presence of separate staff for taking care of newborn significantly reduced the time in early breastfeeding initiation. Initiation time was found longer if the mother had an augmented labour, obstetric complications, and the newborn needed resuscitation. However, the initiation time was significantly early if the baby was put skin-to-skin on mother’s abdomen and received a postnatal examination by a provider. After controlling for the potential confounders, the odds of initiating breastfeeding within one hour of birth is higher if mother gives birth in a district hospital (AOR 3.0: 95% CI 1.5, 6.2), privacy is well-maintained (AOR 2.3: 95% CI 1.1, 4.5), babies cry spontaneously (AOR 7.7: 95% CI 3.3, 17.8), babies are put to skin-to-skin contact with mother (AOR 4.6: 95% CI 1.9, 11.2) and if the baby is examined by a provider in the facility (AOR 4.4: 95% CI 1.4, 14.2). The evidence generated by this study will hopefully direct the policymakers to identify and prioritize the scopes for creating and supporting early initiation of breastfeeding in the health facilities.

Keywords: Bangladesh, early initiation of breastfeeding, health facility, normal vaginal delivery, skin to skin contact

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45112 Pharmacokinetic Modeling of Valsartan in Dog following a Single Oral Administration

Authors: In-Hwan Baek

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Valsartan is a potent and highly selective antagonist of the angiotensin II type 1 receptor, and is widely used for the treatment of hypertension. The aim of this study was to investigate the pharmacokinetic properties of the valsartan in dogs following oral administration of a single dose using quantitative modeling approaches. Forty beagle dogs were randomly divided into two group. Group A (n=20) was administered a single oral dose of valsartan 80 mg (Diovan® 80 mg), and group B (n=20) was administered a single oral dose of valsartan 160 mg (Diovan® 160 mg) in the morning after an overnight fast. Blood samples were collected into heparinized tubes before and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12 and 24 h following oral administration. The plasma concentrations of the valsartan were determined using LC-MS/MS. Non-compartmental pharmacokinetic analyses were performed using WinNonlin Standard Edition software, and modeling approaches were performed using maximum-likelihood estimation via the expectation maximization (MLEM) algorithm with sampling using ADAPT 5 software. After a single dose of valsartan 80 mg, the mean value of maximum concentration (Cmax) was 2.68 ± 1.17 μg/mL at 1.83 ± 1.27 h. The area under the plasma concentration-versus-time curve from time zero to the last measurable concentration (AUC24h) value was 13.21 ± 6.88 μg·h/mL. After dosing with valsartan 160 mg, the mean Cmax was 4.13 ± 1.49 μg/mL at 1.80 ± 1.53 h, the AUC24h was 26.02 ± 12.07 μg·h/mL. The Cmax and AUC values increased in proportion to the increment in valsartan dose, while the pharmacokinetic parameters of elimination rate constant, half-life, apparent of total clearance, and apparent of volume of distribution were not significantly different between the doses. Valsartan pharmacokinetic analysis fits a one-compartment model with first-order absorption and elimination following a single dose of valsartan 80 mg and 160 mg. In addition, high inter-individual variability was identified in the absorption rate constant. In conclusion, valsartan displays the dose-dependent pharmacokinetics in dogs, and Subsequent quantitative modeling approaches provided detailed pharmacokinetic information of valsartan. The current findings provide useful information in dogs that will aid future development of improved formulations or fixed-dose combinations.

Keywords: dose-dependent, modeling, pharmacokinetics, valsartan

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45111 Changing Faces of the Authoritarian Reflex and Islamist Actors in the Maghreb and Mashreq after Arab Uprisings

Authors: Nur Köprülü

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One of the main questions that have arisen after the Arab uprisings has centered on whether they will lead to democratic transition and what the roles of Islamist actors will be. It has become apparent today that one of the key outcomes has been the partial, if not total, overthrow of authoritarian regimes in some cases. So, this article aims to analyse three synchronous upshots brought about by the uprisings, referring to patterns of state formation in the Maghreb and Mashreq. One of the main outcomes has been the persistence of authoritarianism in various forms, and the fragility of the Arab republics coping with the protests as compared to the more resilient character of the monarchies. In addition, none of the uprisings has brought an Islamist organization to incontestable power, as some predicted. However, ‘old’ Islamist actors have since re-emerged as key players, namely the Muslim Brotherhood in Tunisia, Egypt, Jordan and elsewhere. Thus, to understand the synthesis of change and continuity in the Middle East in the aftermath of the Arab Spring, analysing the changing faces of authoritarianism in the region and the impact on Islamists in both the Maghreb and the Mashreq is imperative.

Keywords: authoritarianism, democratization, Arab spring, Islamists

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45110 A Multi-Regional Structural Path Analysis of Virtual Water Flows Caused by Coal Consumption in China

Authors: Cuiyang Feng, Xu Tang, Yi Jin

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Coal is the most important primary energy source in China, which exerts a significant influence on the rapid economic growth. However, it makes the water resources to be a constraint on coal industry development, on account of the reverse geographical distribution between coal and water. To ease the pressure on water shortage, the ‘3 Red Lines’ water policies were announced by the Chinese government, and then ‘water for coal’ plan was added to that policies in 2013. This study utilized a structural path analysis (SPA) based on the multi-regional input-output table to quantify the virtual water flows caused by coal consumption in different stages. Results showed that the direct water input (the first stage) was the highest amount in all stages of coal consumption, accounting for approximately 30% of total virtual water content. Regional analysis demonstrated that virtual water trade alleviated the pressure on water use for coal consumption in water shortage areas, but the import of virtual water was not from the areas which are rich in water. Sectoral analysis indicated that the direct inputs from the sectors of ‘production and distribution of electric power and heat power’ and ‘Smelting and pressing of metals’ took up the major virtual water flows, while the sectors of ‘chemical industry’ and ‘manufacture of non-metallic mineral products’ importantly but indirectly consumed the water. With the population and economic growth in China, the water demand-and-supply gap in coal consumption would be more remarkable. In additional to water efficiency improvement measures, the central government should adjust the strategies of the virtual water trade to address local water scarcity issues. Water resource as the main constraints should be highly considered in coal policy to promote the sustainable development of the coal industry.

Keywords: coal consumption, multi-regional input-output model, structural path analysis, virtual water

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45109 Promotion of Healthy Food Choices in School Children through Nutrition Education

Authors: Vinti Davar

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Introduction: Childhood overweight increases the risk for certain medical and psychological conditions. Millions of school-age children worldwide are affected by serious yet easily treatable and preventable illnesses that inhibit their ability to learn. Healthier children stay in school longer, attend more regularly, learn more and become healthier and more productive adults. Schools are an important setting for nutrition education because one can reach most children, teachers and parents. These years offer a key window for shaping their lifetime habits, which have an impact on their health throughout life. Against this background, an attempt was made to impart nutrition education to school children in Haryana state of India to promote healthy food choices and assess the effectiveness of this program. Methodology: This study was completed in two phases. During the first phase, pre-intervention anthropometric and dietary survey was conducted; the teaching materials for nutrition intervention program were developed and tested; and the questionnaire was validated. In the second phase, an intervention was implemented in two schools of Kurukshetra, Haryana for six months by personal visits once a week. A total of 350 children in the age group of 6-12 years were selected. Out of these, 279 children, 153 boys and 126 girls completed the study. The subjects were divided into four groups namely: underweight, normal, overweight and obese based on body mass index-for-age categories. A power point colorful presentation to improve the quality of tiffin, snacks and meals emphasizing inclusion of all food groups especially vegetables every day and fruits at least 3-4 days per week was used. An extra 20 minutes of aerobic exercise daily was likewise organized and a healthy school environment created. Provision of clean drinking water by school authorities was ensured. Selling of soft drinks and energy-dense snacks in the school canteen as well as advertisements about soft drink and snacks on the school walls were banned. Post intervention, anthropometric indices and food selections were reassessed. Results: The results of this study reiterate the critical role of nutrition education and promotion in improving the healthier food choices by school children. It was observed that normal, overweight and obese children participating in nutrition education intervention program significantly (p≤0.05) increased their daily seasonal fruit and vegetable consumption. Fat and oil consumption was significantly reduced by overweight and obese subjects. Fast food intake was controlled by obese children. The nutrition knowledge of school children significantly improved (p≤0.05) from pre to post intervention. A highly significant increase (p≤0.00) was noted in the nutrition attitude score after intervention in all four groups. Conclusion: This study has shown that a well-planned nutrition education program could improve nutrition knowledge and promote positive changes in healthy food choices. A nutrition program inculcates wholesome eating and active life style habits in children and adolescents that could not only prevent them from chronic diseases and early death but also reduce healthcare cost and enhance the quality of life of citizens and thereby nations.

Keywords: children, eating habits healthy food, obesity, school going, fast foods

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45108 Assessment of Groundwater Chemistry and Quality Characteristics in an Alluvial Aquifer and a Single Plane Fractured-Rock Aquifer in Bloemfontein, South Africa

Authors: Modreck Gomo

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The evolution of groundwater chemistry and its quality is largely controlled by hydrogeochemical processes and their understanding is therefore important for groundwater quality assessments and protection of the water resources. A study was conducted in Bloemfontein town of South Africa to assess and compare the groundwater chemistry and quality characteristics in an alluvial aquifer and single-plane fractured-rock aquifers. 9 groundwater samples were collected from monitoring boreholes drilled into the two aquifer systems during a once-off sampling exercise. Samples were collected through low-flow purging technique and analysed for major ions and trace elements. In order to describe the hydrochemical facies and identify dominant hydrogeochemical processes, the groundwater chemistry data are interpreted using stiff diagrams and principal component analysis (PCA), as complimentary tools. The fitness of the groundwater quality for domestic and irrigation uses is also assessed. Results show that the alluvial aquifer is characterised by a Na-HCO3 hydrochemical facie while fractured-rock aquifer has a Ca-HCO3 facie. The groundwater in both aquifers originally evolved from the dissolution of calcite rocks that are common on land surface environments. However the groundwater in the alluvial aquifer further goes through another evolution as driven by cation exchange process in which Na in the sediments exchanges with Ca2+ in the Ca-HCO3 hydrochemical type to result in the Na-HCO3 hydrochemical type. Despite the difference in the hydrogeochemical processes between the alluvial aquifer and single-plane fractured-rock aquifer, this did not influence the groundwater quality. The groundwater in the two aquifers is very hard as influenced by the elevated magnesium and calcium ions that evolve from dissolution of carbonate minerals which typically occurs in surface environments. Based on total dissolved levels (600-900 mg/L), groundwater quality of the two aquifer systems is classified to be of fair quality. The negative potential impacts of the groundwater quality for domestic uses are highlighted.

Keywords: alluvial aquifer, fractured-rock aquifer, groundwater quality, hydrogeochemical processes

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45107 Speed Optimization Model for Reducing Fuel Consumption Based on Shipping Log Data

Authors: Ayudhia P. Gusti, Semin

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It is known that total operating cost of a vessel is dominated by the cost of fuel consumption. How to reduce the fuel cost of ship so that the operational costs of fuel can be minimized is the question that arises. As the basis of these kinds of problem, sailing speed determination is an important factor to be considered by a shipping company. Optimal speed determination will give a significant influence on the route and berth schedule of ships, which also affect vessel operating costs. The purpose of this paper is to clarify some important issues about ship speed optimization. Sailing speed, displacement, sailing time, and specific fuel consumption were obtained from shipping log data to be further analyzed for modeling the speed optimization. The presented speed optimization model is expected to affect the fuel consumption and to reduce the cost of fuel consumption.

Keywords: maritime transportation, reducing fuel, shipping log data, speed optimization

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45106 Improvement in Drying Characteristics of Raisin by Carbonic Maceration– Process Optimization

Authors: Nursac Akyol, Merve S. Turan, Mustafa Ozcelik, Erdogan Kucukoner, Erkan Karacabey

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Traditional raisin production is a long time drying process under sunlight. During this procedure, grapes are open to some environmental effects besides the adverse effects of the long drying period. Thus, there is a need to develop an alternative method being applicable instead of traditional one. To this extent, a combination of a potential pretreatment (carbonic maceration, CM) with convectional oven drying was examined. CM application was used in raisin production (grape drying) as a pretreatment process before oven drying. Pressure, temperature and time were examined as application parameters of CM. In conventional oven drying, the temperature is a process variable. The aim is to find out how CM and convectional drying processes affect the drying characteristics of grapes as well as their physical and chemical properties. For this purpose, the response surface method was used to determine both the effects of the variables and the optimum pretreatment and drying conditions. The optimum conditions of CM for raisin production were 0.3 MPa of pressure value, 4°C of application temperature and 8 hours of application time. The optimized drying temperature was 77°C. The results showed that the application of CM before the drying process improved the drying characteristics. Drying took only 389 minutes for grapes pretreated by CM under optimum conditions and 495 minutes for the control group dried only by the conventional drying process. According to these results, a decrease of 21% was achieved in the time requirement for raisin production. Also, it was observed that the samples dried under optimum conditions had similar physical properties as those the control group had. It was seen that raisin, which was dried under optimum conditions were in better condition in terms of some of the bioactive contents compared to control groups. In light of all results, it is seen that CM has an important potential in the industrial drying of grape samples. The current study was financially supported by TUBITAK, Turkey (Project no: 116R038).

Keywords: drying time, pretreatment, response surface methodlogy, total phenolic

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45105 Thermal Buckling Analysis of Functionally Graded Beams with Various Boundary Conditions

Authors: Gholamreza Koochaki

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This paper presents the buckling analysis of functionally graded beams with various boundary conditions. The first order shear deformation beam theory (Timoshenko beam theory) and the classical theory (Euler-Bernoulli beam theory) of Reddy have been applied to the functionally graded beams buckling analysis The material property gradient is assumed to be in thickness direction. The equilibrium and stability equations are derived using the total potential energy equations, classical theory and first order shear deformation theory assumption. The temperature difference and applied voltage are assumed to be constant. The critical buckling temperature of FG beams are upper than the isotropic ones. Also, the critical temperature is different for various boundary conditions.

Keywords: buckling, functionally graded beams, Hamilton's principle, Euler-Bernoulli beam

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45104 A Neural Network for the Prediction of Contraction after Burn Injuries

Authors: Ginger Egberts, Marianne Schaaphok, Fred Vermolen, Paul van Zuijlen

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A few years ago, a promising morphoelastic model was developed for the simulation of contraction formation after burn injuries. Contraction can lead to a serious reduction in physical mobility, like a reduction in the range-of-motion of joints. If this is the case in a healing burn wound, then this is referred to as a contracture that needs medical intervention. The morphoelastic model consists of a set of partial differential equations describing both a chemical part and a mechanical part in dermal wound healing. These equations are solved with the numerical finite element method (FEM). In this method, many calculations are required on each of the chosen elements. In general, the more elements, the more accurate the solution. However, the number of elements increases rapidly if simulations are performed in 2D and 3D. In that case, it not only takes longer before a prediction is available, the computation also becomes more expensive. It is therefore important to investigate alternative possibilities to generate the same results, based on the input parameters only. In this study, a surrogate neural network has been designed to mimic the results of the one-dimensional morphoelastic model. The neural network generates predictions quickly, is easy to implement, and there is freedom in the choice of input and output. Because a neural network requires extensive training and a data set, it is ideal that the one-dimensional FEM code generates output quickly. These feed-forward-type neural network results are very promising. Not only can the network give faster predictions, but it also has a performance of over 99%. It reports on the relative surface area of the wound/scar, the total strain energy density, and the evolutions of the densities of the chemicals and mechanics. It is, therefore, interesting to investigate the applicability of a neural network for the two- and three-dimensional morphoelastic model for contraction after burn injuries.

Keywords: biomechanics, burns, feasibility, feed-forward NN, morphoelasticity, neural network, relative surface area wound

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45103 Diagnosis of Logistics Processes: Bibliometric Review and Analysis

Authors: S. F. Bayona, J. Nunez, D. Paez

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The diagnostic processes have been consolidated as fundamental tools in the adequate knowledge of organizations and their processes. The diagnosis is related to the interpretation of the data, findings and the relevant information, to determine problems, causes, or the simple state and behavior of a process, without including a solution to the problems detected. The objective of this work is to identify the necessary stages to diagnose the logistic processes in a metalworking company, from the literary revision of different disciplines. A total of 62 articles were chosen to identify, through bibliometric analysis, the most cited articles, as well as the most frequent authors and journals. The results allowed to identify the two fundamental stages in the diagnostic process: a primary phase (general) based on the logical subjectivity of the knowledge of the person who evaluates, and the secondary phase (specific), related to the interpretation of the results, findings or data. Also, two phases were identified, one related to the definition of the scope of the actions to be developed and the other, as an initial description of what was observed in the process.

Keywords: business, diagnostic, management, process

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45102 Knowledge State of Medical Students in Morocco Regarding Metabolic Dysfunction Associated with Non-alcoholic Fatty Liver Disease (MASLD)

Authors: Elidrissi Laila, El Rhaoussi Fatima-Zahra, Haddad Fouad, Tahiri Mohamed, Hliwa Wafaa, Bellabah Ahmed, Badre Wafaa

Abstract:

Introduction: Metabolic Dysfunction Associated with Non-Alcoholic Fatty Liver Disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is the leading cause of chronic liver disease. The cardiometabolic risk factors associated with MASLD represent common health issues and significant public health challenges. Medical students, being active participants in the healthcare system and a young demographic, are particularly relevant for understanding this entity to prevent its occurrence on a personal and collective level. The objective of our study is to assess the level of knowledge among medical students regarding MASLD, its risk factors, and its long-term consequences. Materials and Methods: We conducted a descriptive cross-sectional study using an anonymous questionnaire distributed through social media over a period of 2 weeks. Medical students from various faculties in Morocco answered 22 questions about MASLD, its etiological factors, diagnosis, complications, and principles of treatment. All responses were analyzed using the Jamovi software. Results: A total of 124 students voluntarily provided complete responses. 59% of our participants were in their 3rd year, with a median age of 21 years. Among the respondents, 27% were overweight, obese, or diabetic. 83% correctly answered more than half of the questions, and 77% believed they knew about MASLD. However, 84% of students were unaware that MASLD is the leading cause of chronic liver disease, and 12% even considered it a rare condition. Regarding etiological factors, overweight and obesity were mentioned in 93% of responses, and type 2 diabetes in 84%. 62% of participants believed that type 1 diabetes could not be implicated in MASLD. For 83 students, MASLD was considered a diagnosis of exclusion, while 41 students believed that a biopsy was mandatory for diagnosis. 12% believed that MASLD did not lead to long-term complications, and 44% were unaware that MASLD could progress to hepatocellular carcinoma. Regarding treatment, 85% included weight loss, and 19% did not consider diabetes management as a therapeutic approach for MASLD. At the end of the questionnaire, 89% of the students expressed a desire to learn more about MASLD and were invited to access an informative sheet through a hyperlink. Conclusion: MASLD represents a significant public health concern due to the prevalence of its risk factors, notably the obesity pandemic, which is widespread among the young population. There is a need for awareness about the seriousness of this emerging and long-underestimated condition among young future physicians.

Keywords: MASLD, medical students, obesity, diabetes

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45101 A Systematic Review of Forest School for Early Childhood Education in China: Lessons Learned from European Studies from a Perspective of Ecological System

Authors: Xiaoying Zhang

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Forest school – an outdoor educational experience that is undertaken in an outdoor environment with trees – becomes an emerging field of early childhood education recently. In China, the benefits of natural outdoor education to children and young people’s wellness have raised attention. Although different types of outdoor-based activities have been involved in some pre-school of China, few study and practice have been conducted in terms of the notion of forest school. To comprehend the impact of forest school for children and young people, this study aims to systematically review articles on the topic of forest school in preschool education from an ecological perspective, i.e. from individual level (e.g., behavior and mental health) to microsystem level (e.g., the relationship between teachers and children) to ecosystem level. Based on PRISMA framework flow, using the key words of “Forest School” and “Early Childhood Education” for searching in Web-of-science database, a total of 33 articles were identified. Sample participants of 13 studies were not preschool children, five studies were not on forest school theme, and two literature review articles were excluded for further analysis. Finally, 13 articles were eligible for thematic analysis. According to Bronfenbrenner's ecological systems theory, there are some fingdings, on the individual level, current forest school studies are concerned about the children behavioral experience in forest school, how these experience may relate to their achievement or to develop children’s wellbeing/wellness, and how this type of learning experience may enhance children’s self-awareness on risk and safety issues. On the microsystem/mesosystem level, this review indicated that pedagogical development for forest school, risk perception from teachers and parents, social development between peers, and adult’s role in the participation of forest school were concerned, explored and discussed most frequently. On the macrosystem, the conceptualization of forest school is the key theme. Different forms of presentation in various countries with diverse cultures could provide various models of forest school education. However, there was no study investigating forest school on an ecosystem level. As for the potential benefits of physical health and mental wellness that results from forest school, it informs us to reflect the system of preschool education from the ecological perspective for Chinese children. For instance, most Chinese kindergartens ignored the significance of natural outdoor activities for children. Preschool education in China is strongly oriented by primary school system, which means pre-school children are expected to be trained as primary school students to do different subjects, such as math. Hardly any kindergarteners provide the opportunities for children and young people to take risks in a natural environment like forest school does. However, merely copying forest school model for a Chinese preschool education system will be less effective. This review of different level concerns could inform us that the localization the idea of forest school to adapt to a Chinese political, educational and cultural background. More detailed results and profound discussions will be presented in the full paper.

Keywords: early childhood education, ecological system, education development prospects in China, forest school

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